Individual
CARRIE MARIE CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S., CADC1
Contact information
Practice address
1003 E MAIN ST STE 104, MEDFORD, OR 97504
(541) 326-4905
(541) 608-2888
Mailing address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 326-4905
(541) 608-2888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08-12-06
OR
Other
Enumeration date
01/06/2011
Last updated
04/17/2019
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